Todd Hillard tried half a dozen different antidepressants before turning to prescription ketamine.
Nothing changed the severe depression and intrusive suicidal thoughts that began in 2010 after Hillard responded to an incident as a police officer. He tried to disarm a woman who held a gun to her head only for him to shoot her. The Christchurch earthquake where he was a first responder further strained his mental health.
“My body went into a constant fight-or-flight response mode,” he said, after the 12 hours he spent digging for earthquake survivors.
Now, 14 years later and six months of taking slow-release ketamine capsules every few days, Hillard’s depression is starting to lift. An attack of suicidal thoughts has gone away unless it is specifically triggered.
“I’m thankful for it because I’ve tried everything else,” said Hillard, a small business owner and father of two in Papamoa. “Sadly, the evidence is that it works for me and I don’t think it’s something anyone should be afraid of.”
Hillard’s success with ketamine is made possible by Antris, the only clinic in New Zealand willing to prescribe ketamine for mood disorders despite growing evidence the drug can quickly and safely treat so-called Treat resistant depression.
A celebrity case of ketamine abuse
Ketamine is already routinely used as an anesthetic in New Zealand emergency departments and operating rooms, as well as in veterinary settings. However, it is widely known as the party drug “Special K” that was at the center of actor Matthew Perry’s death last year.
The Friends star used drugs to treat depression but an autopsy revealed she was illegally self-medicating at home. So far, five people have been arrested in connection with his murder.
Entrees, based in Tauranga, is run by Dr Caleb Armstrong, a psychiatrist who believes ketamine should be widely available to the estimated 100,000 New Zealanders who do not respond to conventional treatment for depression. .
“Some people become very debilitated by their anxiety and are completely symptom-free within a few months,” Armstrong said, citing a 60% success rate of ketamine with treatment-resistant depression, depression that At least it didn’t go down after trying. Two different antidotes
Ketamine can be prescribed off-label
Medsafe has approved ketamine as an anesthetic and it can be prescribed off-label for depression. The clinic currently works with around 80 patients and has treated over 300 people since opening in 2017.
Anthony, a 38-year-old patient of Armstrong’s, described prescription ketamine as a “psychological revitalization” after years of depression. “I lacked motivation, was unable to experience happiness, had suicidal thoughts from time to time,” said the Auckland resident, who works in public health.
Anthony said that he did not think about the short-term psychological side effects that could be transferred to other patients (but followed by illegal drug users). He has been taking it continuously for about a year and now only takes it when he feels he needs it.
“Ketamine is a bit of an opposite ground where drugs that can be used like fentanyl, people take it and they become addicted very quickly,” Armstrong said. “What we see with ketamine is the opposite. They get used to the side effects but after a while they want to take it more frequently or reduce the dose.”
Traditional antidepressants take weeks to take effect where studies show that ketamine can have an effect within 24 hours. It does so by enhancing the brain’s ability to form new connections, according to a 2019 study from the University of Auckland, which added to the body of new evidence supporting ketamine’s effectiveness. However, the long-term benefits and side effects as well as the effects of ketamine on developing adolescent brains are still unknown.
So, why aren’t more medical professionals in New Zealand willing to recommend it? Armstrong believes there is a lack of experience and trust in the mental health community regarding ketamine.
Armstrong, who went to medical school at the University of Auckland, first encountered ketamine in emergency rooms where it was used safely as an anesthetic, including in children. He became a psychiatrist in 2012 and found mentors in Australia, where ketamine is commonly used for depression, to help him set up his own clinic in Tauranga.
The United States approved ketamine as a treatment for depression in 2019. There are already hundreds of thousands of daily clinics that offer services such as intravenous infusions as well as luxury residential programs.
Advances in psychology
University of Otago Professor Paul Glow, who studies ketamine, believes New Zealand psychiatrists are growing in their understanding of the drug’s usefulness but not everyone else’s. Glo said he met Armstrong a few years ago when he was preparing to open Antares and called him a “good quality psychiatrist.”
Another factor preventing access to ketamine for depression is cost, which Pharmac does not subsidize. The first three months of treatment at Antris, a private clinic, is $7,500, including an initial evaluation, monitoring to determine the correct dosage and medication. It will increase to $9,500 so patients can also receive treatment with their ketamine.
“It helps us to help the person holistically during those three months,” Armstrong said.
Patients must travel to Tauranga for their first appointment and leave with a month’s worth of ketamine. This dose is then monitored through regular phone calls and emails with the clinician and reduced or increased as needed. The clinic works with a compounding pharmacy to make the capsules, which are sent to patients using a special courier service for $100 to $200 a month.
The 28-year-old woman from Auckland said: “It’s very expensive. I was very happy that my family funded it for me.”
(Administration at Antares clearly needs improvement. The clinic has a two-star rating on Google, although many comments criticize the administration and praise the mental health treatment).
The social stigma of ketamine as a party drug is also being removed. “People just think you’re high and don’t know there’s a therapeutic use for it,” said the Auckland woman, who works in commercial real estate.
She has been taking ketamine for about a year and no longer needs it. “I think it’s a really effective option,” she said.
By Serena Solomon rnz.co.nz
#ketamine #depression #Zealand